Corneal endothelial cell protection with Viscoat and Healon or Healon alone during penetrating keratoplasty.

Purpose: To determine the influence of dispersive ophthalmic viscosurgical products (OVPs) on corneal endothelial cell (CEC) density during penetrating keratoplasty (PKP) and on the postoperative intraocular pressure (IOP).

Methods: In 117 eyes of 113 patients, PKP was performed by a single surgeon from April 1, 1998 to April 30, 2002. Loss of CECs and postoperative IOP were evaluated retrospectively after use of Viscoat (sodium hyaluronate 3.0%, chondroitin sulfate 4.0%) plus Healon (sodium hyaluronate 1.0%) (Viscoat/Healon group) or Healon alone (Healon group) during surgery.

Results: The average CEC loss was 14.6 +/- 15.5% and 9.0 +/- 10.5% at 1 month, 18.1 +/- 14.6% and 10.1 +/- 7.3% at 3 months, 20.1 +/- 16.3% and 12.2 +/- 10.9% at 6 months, and 31.7 +/- 21.4% and 18.1 +/- 15.5% at 12 months in the Healon (n = 74) and Viscoat/Healon (n = 43) groups, respectively. Patients were stratified into groups with corneal leukoma (n = 61) or bullous keratopathy (n = 56). Loss of CECs was significantly smaller in the Viscoat/Healon group compared with the Healon group irrespective of whether patients had corneal leukoma or bullous keratopathy at 3, 6, and 12 months postoperatively. There was no significant difference of postoperative IOP between the Healon and Viscoat/Healon groups over 12 months of follow-up.

Conclusion: These results suggest that the addition of Viscoat to Healon decreases CEC loss during PKP and does not affect postoperative IOP.